Healthcare Provider Details

I. General information

NPI: 1538073622
Provider Name (Legal Business Name): HEALTHY MIND BEHAVIORAL AND MENTAL HEALTH
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/28/2026
Last Update Date: 09/28/2026
Certification Date: 09/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

110 N WAYNE AVE
WAYNESBORO VA
22980-4524
US

IV. Provider business mailing address

110 N WAYNE AVE
WAYNESBORO VA
22980-4524
US

V. Phone/Fax

Practice location:
  • Phone: 573-289-2716
  • Fax:
Mailing address:
  • Phone: 573-289-2716
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number
License Number StateNULL

VIII. Authorized Official

Name: LAWRENCIA OPPONG PEPRAH
Title or Position: OWNER
Credential:
Phone: 573-289-2716